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An ingrown eyelash grows in the wrong direction, towards the eye. The medical term for this growth is trichiasis.

An ingrown eyelash can touch the eyeball, irritating the eyeball or surrounding skin. This may lead to pain, redness, watery eyes, and damage to the cornea. Trichiasis can be caused by injury, inflammation, and some eye conditions.

Like other ingrown hairs, eyelashes can also become trapped under the skin and grow inward. This can cause symptoms similar to those of eye disorders, such as styes, which usually result from bacterial infection. It is important to identify and treat the problem correctly.

In this article, we look at the causes, symptoms, and treatments of an ingrown eyelash.

What is an ingrown eyelash?

Most ingrown hairs become trapped under the skin, creating a painful bump. The sheath of cells surrounding the hair, called the hair follicle, may become infected. This can all be especially painful when an eyelash is involved.

Trichiasis is slightly different. The eyelash grows outside the skin, but in the wrong direction. Eyelashes on the upper eyelid usually grow upward toward the forehead, allowing them to catch debris and protect the eye. Trichiasis causes these eyelashes to curl down and inward, toward the eye.

On the lower eyelid, where eyelashes typically grow downward, trichiasis causes them to grow upward toward the eye.

Trichiasis can even cause the lashes to touch the eye, causing irritation. A person may feel like there is something in the eye.

Trichiasis is more common in adults than children, but it can occur in anyone.

Identification

An eyelash trapped under the skin can easily be mistaken for an infected gland in the eyelid, called a stye. A stye looks like a pimple or red lump. It usually drains on its own after several days. If the pain is intense or the stye does not go away, antibiotics can treat the infection.

However, a person can easily distinguish a stye from trichiasis, which is characterized by a reversal of eyelash direction.

Symptoms

Trichiasis can occur in a few eyelashes, but it can gradually affect many or all of the eyelashes.

Most people with trichiasis notice a specific area in which many or all of the lashes are growing in the wrong direction.

Changes in eyelash growth can irritate the eye and lead to other symptoms, such as:

a sensation that something is in the eye

redness around the eye

heightened sensitivity to light

watery eyes

itchy or painful eyes

If left untreated, trichiasis can injure the eye, for example by scratching the cornea and exposing the area to infection.

When another eye condition is causing trichiasis, there may be additional symptoms. A condition that often occurs with trichiasis is called blepharitis. This involves inflammation of the eyelid margin, and a person with blepharitis may notice that the skin on their eyelid peels, turns red, collects mucus or is unusually sensitive.

Causes and types

Injury. Scar tissue that develops after an injury can cause eyelashes to grow in a different direction. Eye surgery can also have this effect.

Developmental changes. The eyelashes and hair follicles may temporarily change shape as a child grows. Any resulting trichiasis is usually temporary.

Blepharitis. Chronic blepharitis involves inflammation and irritation of the eyelid, which may cause the skin to peel, turn red, and collect mucus and bacteria.

Entropion. This condition causes the eyelid to fold inward, which can lead to trichiasis. Age-related muscle and tissue weakness can cause entropion, as can infection or injury.

Herpes of the eye. Herpes can infect the eye and damage the eyelid, causing trichiasis.

Trachoma. Trachoma is a severe eyelid infection that can impact the eyelashes and even cause blindness. Trachoma is more common in developing countries.

In rare cases, chronic illnesses that affect the eyelids or mucous membranes, such as Stevens-Johnson syndrome, cause trichiasis.

Treatments

A doctor may be able to remove ingrown eyelashes.

When just a few eyelashes are misshapen or ingrown, a doctor will usually remove them. They may regrow in the right direction. It is also important to treat the underlying cause.

When many eyelashes are ingrown, or when eyelashes regrow in the wrong direction, the following treatments can help:

Permanent hair removal

An ingrown eyelash can be removed using electrolysis. A doctor will damage the follicle with an electric current to prevent the hair from re-growing. Several sessions may be necessary.

Laser hair removal is an alternative, and a 2015 study compared its effectiveness to that of electrolysis. Laser hair removal had a first-time success rate of 81 percent, with just 19 percent of targeted lashes regrowing. The first-time success rate of electrolysis was 49 percent, with 63 percent of the lashes regrowing.

Cryosurgery

This procedure is designed to freeze off the affected lashes and their follicles.

Repositioning surgery

A doctor can surgically reposition an eyelid or eyelashes. A 2015 review of the various treatment techniques for trichiasis suggested that surgery was most effective for people with trachoma.

Complications

Anyone who suspects that they have an ingrown eyelash should see an eye doctor. If there is an underlying cause, identifying it can prevent further damage.

Outlook

Trichiasis can be annoying and painful. Though it sometimes clears on its own, many people try several treatments before finding one that works.

A doctor specializing in eye and eyelid conditions can help to diagnose the cause, discuss the most effective treatment options, and suggest prevention strategies. A person who suspects that they have an ingrown eyelash should see an ophthalmologist or optometrist.

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